Study: The US drug overdose crisis is worst among rich nations

America's opioid epidemic has shot overall drug overdose to record numbers – with overdose deaths that hit 70,000 in 2017, kill more people annually than guns, car accidents or HIV / Aids ever in & # 39; a few years in American history. But a new study confirms the level of overdose death is not just out of historical norms for the US; It is also far beyond the norm among rich nations around the world.

The study by the University of Southern California, researcher Jessica Ho, compared the US to 17 other rich nations and found that America's level of overdose deaths exceeded the other nations for more than a decade .

Based on data from around the world, the study, published in Population and Development Review found that the mid-1990s was the drug attack in the US. largely in line with those of other developed countries. At that time, Sweden and Finland led the 18 rich nations into overdose deaths.

But as the opioid crisis declined in the late 1990s in the US – as pharmaceutical marketing and lobbying, doctors prescribed much more opioid painkillers, and abuse and addiction increased – America exceeded other countries in overdose deaths.

A second wave of drug overdosage began in the 2000s when heroin flooded the illegal market because drug dealers benefited from a new population of people using opioids but either lost access to painkillers or just sought a better, cheaper high. When a third wave of overdose started, as illegal fentanyl, a synthetic opioid, replaced heroin in the black market, causing a further peak in overdose, as fentaniles generally is stronger than heroin or other traditionally consumed opioids.

By 2015, the US had the highest overdose mortality rate among any of the countries he studied – by far. The rate was 60 percent higher than in Finland and Sweden, which was once more rich countries. "Drug overdose deaths were on average 3.5 times higher in the US than in the counterparts, although this figure ranges from 1.6 to 28 times higher," Ho wrote.

Here's how the trends look for men, with the top 10 countries marked by different colors in 2003 and the rest uncolored:

Jessica Ho / Population and Development Review

Ho argued that America's high overdose mortality rate is one of the reasons why the US falls behind other countries in the overall life expectancy: "On average, life expectancy was about 2, 6 years lower in the US than in other high-income countries in 2013 for both men and women, and drug overdose accounting for 12 percent and 8 percent of these 2.6-year gaps, respectively. "

The Centers for Disease control and prevention have made similar connections between the current drug overdose crisis and life expectancy, which has linked a rise in overdose deaths in recent years to a share of the decline in life expectancy in the United States. States in 2017.

One caveat for the study: it only draws data until 2015 Since then, the opioid crisis has become even worse, especially since fentanil has continued to spread in illegal drug markets. So the US may be even worse in recent years, though Ho pointed out that evidence that Australia, Canada and the United Kingdom are on a similar trajectory.

There are real solutions to the opioid crisis

Public health and drug policy experts say there are solutions to the opioid crisis. First, America can dramatically increase access to addiction treatment – based on a general report from the 2016 surgeon, remaining inaccessible to most people who need it. It should dramatically increase access to medicines such as methadone and buprenorphine, which are considered the gold standard of opioid addiction treatment and reduce the mortality rate among opioid addiction patients by half or more.

When France relaxed restrictions on doctors prescribing buprenorphine in response to its own opioid crisis in 1995, the number of people in treatment increased and overdose deaths fell by 79% over the next four years.

Except for treatment, prescribers can also cut back on excessive opioid analgesic prescriptions – to prevent more people from abusing the drug – while still ensuring that patients they really need access. Harmony approaches, such as needle swings and more proliferation of opioid overdose anti-naloxone, will also help.

Several countries that have taken this kind of action, based on state and federal data, have dropped death cases or declined in 2017.

In 2017, Vermont found its overdose reduction of death toll by about 6 percent, with the continued expansion of a hub and gambling system that integrates addiction treatment in the rest of the healthcare system. Rhode Island also dropped by about 2% as it, among other things, applied changes, improved access to opioid addiction medication in its prisons and prisons. And Massachusetts has declined by about 3%, along with a public health campaign that emphasizes more addiction treatment, including in emergency rooms, and fewer painkillers.

This is not a big decrease. But they are significant because they are in New England state. This is one of the areas most affected by the opioid crisis and overdose deaths have been increasing over the past few years. Public health interventions may also take time to shoot root as more and more of the public is learning the risk of addiction and the treatment is now really available.

A consistent problem for many countries is lack of federal resources. The congress has been funding more opioid addiction funding over the past year, but the money allocated so far falls short of the tens of millions of dollars that experts say are needed to fully and quickly confront the opioid epidemic. And in spite of cute promises, President Donald Trump has done little to change it.

For more information on the solutions for the opioid epidemic, read Vox & apos; s explainer .